NYC hospitals agree to hire 1.5K nurses, raise wages

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The months-long standoff between the New York State Nurses Association and New York City's three biggest health systems ended atypically, with the hospitals ultimately agreeing to both raise wages 3% and spend $100 million hiring 1,450 nurses.

The agreement between NYSNA and the hospitals — Mount Sinai, Montefiore and New York-Presbyterian — is notable in that New York state does not have laws that would mandate specific nurse-to-patient staffing ratios.

But under the deal,staffing levels will be based on ratios agreed upon in the parties' contracts and "enforced by an independent neutral party," according to a press release from the union.

A New York Senate bill mandating staffing ratios failed last year, but has recently gained the support of Gov. Andrew Cuomo.

Though 14 states have some form of legislation addressing staffing ratios, California is the only one with an expansive mandate and is widely considered the model. Massachussettes union nurses had high hopes of becoming the second with a failed ballot question in November.

NYSNA's agreement could create a shockwave across the northeast. Support for staffing legislation began picking up steam in Connecticut this week. In Eastern Pennsylvania, where bipartisan and gubernatorial support for staffing legislation has been accumulating support, union nurses' excitement was amplified by an encouraging visit from Sen. Bernie Sanders, I-Vt.

Meanwhile, sparring between union nurses and Indiana Regional Medical Center, an independent community hospital in Western Pennsylvania, has been escalating since early April. Negotiations have been ongoing since late 2018, culminating this week with both parties filing unfair labor practice charges against one another. The nurses have been working without a contract sinceOctober, and have made nearly two dozen attempts to negotiate since.

Annie Brisco, a coordinator for that nurses union, told Healthcare Dive in February that the hospital had presented nurses with a "last, best and final offer."

Much like nurses at Indiana Regional Medical Center, about 75 members of the 5,000-member Hawaii Nurses Association have also been working on an expired contract at a small community hospital, where they get paid much less than their colleagues at parent company Queens Health System. The nurses are coming to the negotiating table with a handful of demands, among them being more staff and higher wages.

Winning a staffing battle with three major New York health systems may inspire nurse unions elsewhere to make staffing and wage raises a demand. But it may not work for those outside of major metros, specifically in rural areas where independent community hospitals operate. The patient mix is mostly Medicare and Medicaid patients, the reimbursements are tightening, volumes are decreasing — and the labor pool is too shallow to hire more nurses.

Jefferies analyst Jason Plagman told Healthcare Dive recently about 50% of hospital revenue goes to salary, wages and benefits, with half of that revenue going to nurses. If hospitals give a 3% raise to all nurses, he said, that's a "big impact on their overall expense line."

That's the wage raise NYSNA nurses got from the hospitals' deal. That decision could influence the nurse labor market in New York, and quite possibly in neighboring markets. It might not impact independent community hospitals like IRMC and North Hawaii Community Hospital immediately, but the deal is turning heads.

The impact will be worth watching as jobs grow, wages stagnate and community hospitals whose nurses go on strike — like IRMC's did early in the year — turn to temporary staffing agencies rather than hire more nurses or raise wages.

But even California has had its fair share of labor obstruction. Mental health workers in Pasadena this week authorized another strike against Kaiser, their second for the year, while nurses at Henry Mayo Newhall in Santa Clarita were able to strike a deal just hours after authorizing a strike of their own.